Institute of Medical Microbiology and Hygiene, Eberhard Karls University of Tübingen, Tübingen, Germany.
Chemotherapy. 2012;58(3):241-8. doi: 10.1159/000339488. Epub 2012 Jul 25.
Extended-spectrum β-lactamase (ESBL)-producing organisms are spreading worldwide in hospital and community settings.
A total of 328 unduplicated ESBL-producing Enterobacteriaceae isolated in 2008 and 2009 at the University Hospital of Tübingen were analysed retrospectively.
Escherichia coli (n = 253) and Klebsiella spp. (n = 46) were the most frequent ESBL-producing species. The ESBL rates among E. coli and Klebsiella spp. increased from 3.8 and 2.1%, respectively, in 2008, to 5.2 and 2.4%, respectively, in 2009. Two E. coli and 3 Klebsiella pneumoniae ESBL producers were non-susceptible to ertapenem, most likely due to loss of porins. Antimicrobial susceptibility testing of selected, molecularly characterized ESBL producers revealed susceptibility to tigecycline among 97.9% (191/195) of the E. coli and 78.8% (26/33) of the K. pneumoniae isolates. PCR analysis and sequencing showed the presence of CTX-M-type enzymes in 91.3% of the E. coli and 87.9% of the K. pneumoniae isolates, whereby bla(CTX-M-15) was the most frequent ESBL gene both in E. coli (50.0%) and K. pneumoniae (51.5%). Only 7 single cases of potential patient-to-patient transmissions of E. coli strains were observed.
Our data suggest that the increase in ESBL-producing E. coli and K. pneumoniae isolates at our hospital is mainly caused by growing import of Enterobacteriaceae harbouring CTX-M-type ESBLs.
产超广谱β-内酰胺酶（ESBL）的生物体在医院和社区环境中在全球范围内传播。
回顾性分析了 2008 年和 2009 年图宾根大学医院分离的 328 株非重复产 ESBL 的肠杆菌科。
大肠埃希菌（n=253）和肺炎克雷伯菌（n=46）是最常见的产 ESBL 菌。2008 年大肠埃希菌和肺炎克雷伯菌的 ESBL 发生率分别为 3.8%和 2.1%，2009 年分别为 5.2%和 2.4%。2 株大肠埃希菌和 3 株肺炎克雷伯菌产 ESBL 菌对厄他培南不敏感，很可能是由于孔蛋白丢失。对选择的、分子特征明确的产 ESBL 菌进行药敏试验，结果显示 97.9%（191/195）的大肠埃希菌和 78.8%（26/33）的肺炎克雷伯菌对替加环素敏感。PCR 分析和测序显示，91.3%的大肠埃希菌和 87.9%的肺炎克雷伯菌携带 CTX-M 型酶，其中 bla（CTX-M-15）在大肠埃希菌（50.0%）和肺炎克雷伯菌（51.5%）中是最常见的 ESBL 基因。仅观察到 7 例大肠埃希菌株潜在的患者间传播的情况。
我们的数据表明，我院产 ESBL 的大肠埃希菌和肺炎克雷伯菌分离株的增加主要是由于携带 CTX-M 型 ESBL 的肠杆菌科的进口增加所致。
